The nine Americans killed in an ambush south of the border this week were caught in the crossfire of rival drug cartels, Mexican authorities say they now believe. Which makes these dual citizens, including three mothers and their children, casualties of the opioid crisis, too.

What Mexico’s increasingly powerful transnational criminal organizations are battling over — and the reason gang warfare has reached record heights — is the opportunity to make enormous amounts of money trafficking fentanyl and other synthetic opioids into the United States.

We tend to see the current opioid crisis primarily as the result of lapses in the public health safety net — the outcome of a push by Big Pharma, which created the market for these killer designer drugs in the first place by hooking millions of Americans on prescription pain pills, and the failure of Congress and successive administrations to stop it and provide adequate prevention and treatment programs.

That’s true. But much of the current supply of fentanyl pushing the broader opioid crisis to unprecedented heights is being smuggled into the country by the Sinaloa cartel and its rivals in Mexico.

Black-market fentanyl and other synthetic opioids smuggled in from Mexico and China have become the fastest-growing and most lethal drug in America, far surpassing heroin and the prescription narcotics that often serve as gateway drugs. The surge has been so rapid — from roughly 3,000 deaths in 2013 to more than 30,000 five years later — that synthetic opioid overdoses have now killed more Americans than the wars in Vietnam, Afghanistan and Iraq combined.

The Centers for Disease Control and Prevention (CDC) even has a name for it now: the “third wave” of the opioid crisis. CDC data shows that more than 399,000 people have died from overdoses involving any opioid, including prescription and illicit opioids, from 1999 to 2017.

The first distinct wave of opioid deaths began in the 1990s with the steady increase of prescriptions pushed on Americans by Big Pharma and complicit doctors. The second wave began in 2010, the CDC says, when the backlash over such professional drug pushers prompted a sharp curtailment of supply. That forced users onto the streets, where they began buying heroin and similar illicit drugs, including diverted or stolen supplies of pharmaceutical fentanyl — which is prescribed legally, but rarely, as a potent painkiller for surgery and cancer patients.

Mexico’s transnational organized crime collectives, especially Sinaloa — the cartel made infamous by drug overlord Joaquín “El Chapo” Guzmán — were more than happy to supply whatever was needed to meet the voracious U.S. demand. To do so, they cultivated alliances with Italian and other organized crime mafias, American street gangs, outlaw biker groups and high-tech Asian money launderers.

So the third wave of opioids — the one still ravaging U.S. communities — began in 2013 when Americans found out about fentanyl. Some began buying it direct from brokers in China, where the vast majority of the chemical was manufactured. But Sinaloa, which by then operated in more than 50 countries, and its rivals soon homed in on the drug, too, and began buying vast quantities of it for resale in the United States.

The cartels quickly realized that they could make previously unimaginable profits, with much less risk, from a drug that can be cooked up in a few days in clandestine labs, and in unlimited quantities, than from heroin, which required a time-consuming and expensive process of cultivating and processing poppy plants.

Because fentanyl is so powerful — 50 to 100 times as strong as heroin — the cartels used some of it to cheaply boost the potency of that narcotic or to sell it outright as heroin to unwitting American consumers.

Fentanyl soon developed a reputation as a faster-acting, longer-lasting and more euphoric high. A lot of American users, especially longtime addicts, began asking for fentanyl specifically. In its most recent annual National Drug Threat Assessment, the Drug Enforcement Administration said, “Illicit fentanyl and other synthetic opioids — primarily sourced from China and Mexico — are now the most lethal category of opioids used in the United States.”

More recently, according to DEA, CDC and United Nations data, the cartels have been spiking their U.S.-bound cocaine, methamphetamine and counterfeit pain pills with fentanyl, too, to pack a bigger punch and hook whole new cadres of users.

Now, confidential U.S. intelligence, summarized by officials familiar with it, indicates that Mexico’s two most powerful cartels, Sinaloa and Jalisco New Generation, are moving to dramatically expand their fentanyl trafficking empires in the United States, in part by locally manufacturing the drug themselves, using precursor chemicals from China, instead of buying the finished product there as they had in the past.

They’re still pumping out cheaper and more potent supplies of U.S.-bound methamphetamine. But the cartels are now using those same chemists and industrial-scale laboratories to produce truckloads of pharmaceutical-grade fentanyl, U.S. counternarcotics officials say privately. “And then, with ready-made means of distribution, transportation and smuggling,” warns one of them, who was not authorized to speak publicly, “they’re ready to just obliterate the market.”

The result could be a tsunami of cheap, super-potent, consumer-friendly synthetic opioid products designed to hook whole new demographics of recreational drug users. (In the past, Mexican fentanyl has been much more diluted than the still-thriving direct-mail business from China.) “God help us all when that happens,” the official warned, given how many tens of thousands of Americans have died already from ingesting an amount of fentanyl no larger than a grain of rice.

There are worrisome signs of such an influx already. Some Arizona border towns have reported sharp spikes in young adults and even teenagers dying from fentanyl tablets manufactured to look like oxycodone, Percocet and other painkillers.

Massive amounts of fentanyl are being seized at the border now, and far more is getting through. Thomas Overacker, executive director of cargo and conveyance security for U.S. Customs and Border Protection, told Congress in July that seizures of illicit fentanyl had significantly increased, from about two pounds in fiscal 2013 to about 2,170 pounds in fiscal 2018. CBP had seized as much in the first half of 2019 as it did in all of the prior year, he said, but the agency is able to inspect about 2 percent of cars and 16 percent of commercial vehicles that come across ports of entry at the southwest border.

Given the profit to be made from their vertical integration of the fentanyl trade, the cartel wars have intensified, too, especially over who controls the distribution routes into the United States and the lucrative markets from coast to coast. U.S. and Mexico counternarcotics efforts, including the arrest and conviction of El Chapo, have caused a splintering of cartels that has only intensified the turf battles.

Mexican authorities believe Monday’s massacre was probably related to such an ongoing battle between Sinaloa and other traffickers. Sinaloa still oversees the most extensive overall U.S. drug trafficking operation. But Jalisco New Generation is gaining fast on the fentanyl front. In October 2018, the Trump administration cited that as one reason it was announcing a $10 million bounty in October 2018 for alleged leader Nemesio Ruben “El Mencho” Oseguera Cervantes.

That’s probably also why Sinaloa, now under the leadership of at least three of Guzmán’s sons and his longtime partner Ismael “El Mayo” Zambada García, has doubled down on its U.S. fentanyl operation.

In February, an indictment against two of the Guzmán sons, including 28-year-old Ovidio Guzmán López, was unsealed in New York, alleging that they trafficked heroin and marijuana into the United States. No mention of synthetic opioids was made in that case. But Mexican authorities say it was pressure from Washington to do more about Sinaloa’s cross-border fentanyl trade — and the younger Guzman’s alleged role in it — that prompted them to try to arrest him three weeks ago.

As the world now knows, Mexican authorities arrested the younger Guzmán in a house in the Sinaloa stronghold of Culiacán last month but were forced to let him go after cartel hit men launched a military-style assault on the city, taking hostages, shooting at police and springing cartel associates from at least one prison.

After both recent incidents, President Trump and Mexican President Andrés Manuel López Obrador spoke about what they should do about the drug cartels. Their approaches differ markedly, with Trump tweeting that he wants to “wage WAR” against the cartels and “wipe them off the face of the earth,” and López Obrador insisting that Mexico will take a far more nuanced and long-term approach.

Whatever ends up happening, the one unfortunate certainty is that the flow of fentanyl into the United States, and the overdose deaths of thousands of Americans a year, will continue unabated for now.

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